Medical network on April 12 - expensive, medical care, has been a focus issue. Since April 8, in the Beijing hospital patients will find the registration fee is cancelled, more than a medical service, and prices, examination has changed. Because April 8, the Beijing municipal medical separate formal implementation of comprehensive reform, to participate in more than 3600 hospitals, including all the public medical institutions in Beijing, and the government to buy services, urban and rural basic medical insurance of social do medical establishment that decide a dot, can say involved the most hospitals in Beijing. 

 

Beijing health care according to what change? Why change? 

 

The price of this reform is the biggest change medicine. How much money to buy medicine, hospital, how much money is going to sell to patients, abolish all hospitals to drug addition. After, since the 50 s, has been take medicine to raise medical. In our country, public hospitals operating income mainly by three parts: drug addition, financial aid, and service charges. Financial aid does not arrive at that time, the medical service fee is low, the public hospital when selling drugs on the basis of the purchase price, price by fifteen percent, and the 15% drug and achievement became the mainstay of the hospital operation. 

 

Medicine for the medical, patients burden is heavy, to some extent also affected some doctors raise the enthusiasm of technology. 

 

It is obvious that "medicine for the medical" must be broken. Five years ago, in 2012, Beijing in chaoyang, friendship, the temple of heaven, my colleagues and ji shui tan five level of first-class hospital, to carry out medical separate pilot, cancel 15% of drug addition, the first is to rationalize decades of inherent benefit distribution mechanism. 

 

Chaoyang hospital increased medical cost control, investigate excessive. Started to screen the prescription every day, at the same time, posted on a regular basis and excessive public comment. Now also implements "prescription lead review". Polypharmacy, long cycle of prescriptions and conflicting between medicine and drugs, these drugs common problems, through the information system will be automatically intercept immediately, the artificial in the pharmacist to audit, review, however, prescription, and then open don't come out. 

 

For chaoyang hospital, after five years of reform, the outpatient service time are medicines has fallen by 21%, hospitalization time, medical costs fell by 36%. 

 

Five years down, five pilot hospital medicine proportion decreased from 43% in 2012 to 33% in 2016, a drop was 10%. 

 

According to the new system design, drug commission income this big head be blocked, the hospital how to realize the balance of payments, continue? 

 

Began to implement pilot hospital, to raise the medical service charges, in outpatient service, for example, as defined by the physician rank medical service charge, the pilot of doctor of vice director of general hospital outpatient 42 yuan, 60 yuan, 80 yuan, director of the physician, well-known expert outpatient service 100 yuan. This charge pays Beijing health 40 yuan each time. Some of the medical service charges will be counted in the medical workers performance, promote medicine for medical technology for medical. 

 

It seems to the doctors, the improvement of medical service, embody the respect for the doctor labor value. 

 

The doctor, the cancel addition, registered and fee, increasing the number of medical service, cancel this add translation, can realize the basic balance of the balance of the hospital, and the burden of patients not worse? In the designer's view, cancel the drug addition, additional medical service not only to achieve the interests of the hospital, doctors and patients balanced, more major is, different hospitals, doctors should pay medical service, the price lever to help diagnosis and classification. 

 

"Medicine for the medical" persistent ailment bred out of the "decay in medicine cure", also break down the trust relationship between the patient, apparently to cure the disease have to cancel the drug addition from the beginning. This "disease" is not good, will touch the interests of all aspects, but also is not cannot cure. With five years pilot experience accumulation, Beijing since April 8: the formal implementation of the new medical reform cancel drug addition, cancellation of the registration fee, the fee, additional medical service charge. In addition, also in 435 basic medical service prices are adjusted, the price have rise and fall. It is a principle, basic projects, by material is given priority to with people of technology and service fees. 

 

Is expensive and there is a major spending large medical equipment is expensive, the price reform of choice of 435 projects, the large medical equipment check project price down, such as the head CT from 180 yuan to 135 yuan, nuclear magnetic resonance (NMR) from 850 yuan to 400 yuan to 600 yuan. 

 

And related project price down, related to the people rose up 

 

This is because previously, medical and medicine are inversion phenomenon for a long time. After an appendicitis operation is 234 yuan, you need four to five medical staff work an hour, it has take a scalpel than take a razor. 

 

The reform, the traditional Chinese medicine, nursing, surgery and other medical personnel technical services value, the technical risk big project price will be brought up, mentioned earlier, appendectomy changed from 234 yuan to 234 yuan. These charges has increased, in medical workers, it seems, is sure to own value. 

 

Cancel the drug addition, increasing the number of medical service, medical project price have rise and fall, whether the patients than it used to be cheap or expensive? According to the Beijing health planning commission, according to the measure, adjustment of patients after overall burden level did not increase cost, in terms of individual patients, may be because the illness is different and has different effect. 

 

According to the current price system, to give priority to with drug therapy, or more involved in patients with CT, mri, medical costs will decline. If in technical services in the process of diagnosis and treatment project is given priority to, diagnosis and treatment costs will increase. 

 

From the two days, Beijing's public hospitals generally achieved a smooth transition to the new medical reform policy. Treatment of multiyear rally, not more than medicine, also cannot but doubly cautious, to balance a good hospital, medical staff and patients the interests of all parties. This is why Beijing took five years to grind out the "knife", the word "addition and subtraction. Some costs rise, some costs down, to adjust not only the price, more important is to pass the price adjustment of the whole medical system structural changes, guide the hospital operation mechanism, through the reform, make the doctor takes no account of your people, seeking medical treatment is no longer difficult, also let the hospital, the doctor out "suitable" not humbled. Beijing's new healthcare reform put all of the country may not be appropriate, but from the medicine for the medical, material for medicine, to raise the medical technology, to raise the thinking of medical service represents the direction of the reform.